Healthcare Provider Details

I. General information

NPI: 1356227144
Provider Name (Legal Business Name): OIDP THERAPY GROUP, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2025
Last Update Date: 08/15/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 112 KM 1.2 INTERIOR
ISABELA PR
00662
US

IV. Provider business mailing address

PO BOX 267
ISABELA PR
00662-0267
US

V. Phone/Fax

Practice location:
  • Phone: 787-413-7846
  • Fax:
Mailing address:
  • Phone: 787-413-7846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JAIME A RUIZ
Title or Position: PRESIDENT
Credential:
Phone: 787-413-7846